调脂药物对急性冠状动脉综合征血脂和高敏C反应蛋白及心室重构的影响

The clinical effects of Atorvastatin versus Simvastatin on levels of serum lipid, high-sensitivity C-reactive protein and ventricular remodeling in patients with acute coronary syndrome

目的探讨阿托伐他汀、辛伐他汀治疗急性冠状动脉（冠脉）综合征对患者血脂、高敏c反应蛋白（hs—CRP）和心室重构的影响。方法前瞻性研究，2014年12月至2016年9月期间连续人选本院收治的急性冠脉综合征患者96例，按照随机、对照原则采用数字抽签法将其分为辛伐他汀组和阿托伐他汀组，分别采用辛伐他汀和阿托伐他汀进行治疗，对两组患者治疗前后高敏C反应蛋白、血脂水平及心肌功能的变化情况进行观察。结果在治疗8周时，阿托伐他汀组患者hs—CRP水平、血脂水平改善幅度均优于辛伐他汀组（P〈0．05）；两组患者左心室射血分数（LVEF）、左心室舒张末期容积指数（LVEDVI）均较治疗前改善（P〈0．05），且阿托伐他汀组患者LVEF为（44．8±6．3）％、LVEDVI为62．7±10．4，均优于辛伐他汀组（48．9±6．9）％与67．9±10．5，（均P〈0．05）。结论辛伐他汀、阿托伐他汀均可有效促进冠脉综合征患者血脂和炎症反应程度下降，并有助于促进患者心肌功能改善，其中阿托伐他汀效果更为显著。

Objective To explore the effects of Atorvastatin and Simvastatin on serum levels of lipid, high sensitive C-reactive protein（hs-CRP）and ventrieular remodeling in patients with acute coronary syndromes （ACS）. Methods In this prospective study, 96 patients with acute coronary syndrome were admitted in our hospital from December 2014 to September 2016. In the prospectively study, they were randomized into Atorvastatin group（Atorvastatin 20 mg daily, n = 48）and Simvastatin group（Simvastatin 40 mg daily,n = 48）, and serum levels of hs-CRP, lipids and changes in myocardial function were detected and compared between two groups before and after treatment. Results The serum levels of hs-CRP and lipids were significantly lower in Atorvastatin group than in Simvastatin group at 8 weeks after treatment（P〈0.05）. At the end of the treatment, the levels of left ventricular reject fraction and left ventricular end-diastolic volume index were improved （all P 〈 0.05） in two groups,but significantly higher in Atorvastatin group[（44.8 ± 6.3）% and （62.7 ± 10.4）] than in Simvastatin group [（48.9 ± 6.9 ）% and （67.9 ± 10.5 ） respectively, all P 〈 0.05 ）. Conclusions Simvastatin and Atorvastatin can effectively promote the decrease in levels of blood lipids and inflammatory reaction, and help to improve the myocardial function in patients with acute coronary syndrome,but Atorvastatin effects are more significant.